| Shanti House | |
|
7420 E Lakeside Dr Tucson AZ 85730-3321 | |
| (520) 296-9139 | |
| Not Available |
| Full Name | Shanti House |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7420 E Lakeside Dr, Tucson, Arizona |
| Authorized Official Name and Position | Hepsibah Anjuri (OWNER/PROVIDER) |
| Authorized Official Contact | 5202969139 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanti House 7420 E Lakeside Dr Tucson AZ 85730-3321 Ph: () - | Shanti House 7420 E Lakeside Dr Tucson AZ 85730-3321 Ph: (520) 296-9139 |
| NPI Number | 1609178383 |
|---|---|
| Provider Enumeration Date | 12/01/2010 |
| Last Update Date | 02/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609178383 | NPI | - | NPPES |
| 575563 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH-4445 (Arizona) | Primary |
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